Conquering Fatigue

by Debra Waterhouse, M.P.H., R.D.

(Editor's Note: While this article and the book it is excerpted from are written for women, the information it contains pertains to both genders. Men, as well as women, will greatly benefit from reading the article and following the advice given.)

If this is the first time you've attempted to explore the internal, deeper meaning of your fatigue, a few pitfalls can arise. You may have an extreme answer like Gayle did: "My fatigue is telling me that I need a new job, a new boss, a new husband, a new therapist. Basically, it's telling me that I need a new life."

Your fatigue is not telling you that you need a new life; it's telling you that you need a new outlook on life. One that gives you full permission to take care of your body and make choices that will enhance your health and well-being.

The second pitfall is to immediately blame yourself, as Holly did: "My fatigue is telling me that I'm weak, out of control, not organized enough, and not disciplined enough. It's telling me that I'm a failure in life."

Let's set things straight right up front: Fatigue is not your fault. With the amount you have to accomplish every day, no woman would feel organized. In the continuous marathon of a woman's life, even the Bionic Woman wouldn't have the stamina to go 100 miles an hour day after day without hitting the wall. Let go of any blame you may be feeling. Your fatigue is not telling you that you have a character flaw, a discipline problem, or an organizational impairment.

The third pitfall is to assume that you need megadoses of vitamins or the latest energizing concoction that's hit the market. When Laura thought about what her fatigue was telling her, she was convinced that she "needed ginseng, ginkgo biloba, coenzyme Q10, super blue-green algae, and B12 injections." These and other so-called energy boosters are what we're told we need by the companies that manufacture them. But this is not your body talking. Your body doesn't even know that these pills, potions, and injections exist.

You may feel a lift from some of these products, but the energy is not permanent. Like caffeine, they are an external means of revving you up for a while, but once the effect wears off, the fatigue will come back in full force. You may choose to use them to push through the next hour or two of the day, but your body wouldn't choose them to recharge itself for life.

The fourth and final pitfall is immediately jumping to the conclusion that you have a disease or illness that's causing your fatigue. Karen was convinced that her fatigue was telling her that she had a life-threatening illness. She spent three years going from doctor to doctor looking for a medical cause for her fatigue, only to find that she wasn't ill, just tired. In fact, her medical anxiety and her many appointments had made her even more exhausted.

There are a number of cases, however, in which fatigue may be telling you that it's time to make a doctor's appointment. I would be remiss if I did not provide a brief discussion of the major medical causes of fatigue. It's a symptom of almost every illness and by itself cannot be used for a diagnosis, but in combination with other symptoms, it may be a warning sign of an undiagnosed and untreated medical condition. My goal is not to make you anxious about your state of health but to alert you to the fact that there is a small chance your fatigue is telling you that you may have:

1. Anemia -- either iron deficiency anemia or pernicious anemia from a B12 deficiency. These can be easily diagnosed with a blood test and easily treated with diet and supplements.
   
   
2. Hypothyroidism -- the thyroid gland secretes thyroxin, a hormone that boosts metabolism and energy. "Hypo" means underactive, and an underactive thyroid can bring about sluggishness and fatigue, as well as weight gain, hair loss, dry skin, and a sensitivity to cold. Because hypothyroidism is ten times more common in women than men (especially in women over the age of forty), many health professionals are recommending thyroid screening via a blood test as a standard protocol during an annual exam. If you do find that you have an underactive thyroid, the gland and your energy can be effectively boosted with medication.
   
   
3. Diabetes -- when insulin (the hormone that transports glucose from our bloodstream into our cells) is either low or ineffective, our cells are being deprived of energy. Other signs include excessive hunger, thirst, and urination. When diabetes is controlled by diet, pills, and/or insulin injections, our cells and our bodies are energized by a sufficient supply of glucose.
   
   
4. Hypoglycemia -- the opposite of diabetes, too much insulin can make our blood sugar drop below normal. Low blood sugar levels make us low in energy, but by keeping blood sugar levels stable through dietary changes, a more stable level of energy can be achieved.
   
   
5. Sleep Apnea -- what was once thought to affect only older, overweight men is now recognized as a potential problem for both genders at any age or weight. Often accompanied by snoring, sleep apnea occurs when we periodically stop breathing for as much as twenty seconds due to blocked airway passages. The lack of oxygen at night can cause lack of energy during the day. A number of techniques, devices, and medications are now available to help minimize this condition.
   
   
6. Adrenal Gland Insufficiency -- this is a relatively new term in the medical literature. After years of chronic stress, the adrenal gland can become worn out and produce low levels of the stimulating hormones, cortisol and epinephrine, causing lethargy. Effective treatment is still being researched, but balancing hormones and reducing stress appear to be at least part of the solution.
   
   
7. Clinical Depression -- fatigue is definitely one of the warning signs of depression. But it's one of those chicken-and-egg situations. Which came first? Did the overwhelming fatigue cause the depression or did the depression cause the fatigue? Sometimes it's impossible to know. But if you're depressed, don't waste time trying to figure it out, and instead take the time to take care of yourself through cognitive therapy and/or antidepressants. Every good therapist will help you make changes in your life situation to boost your happiness and your vitality.
   
   
8. Chronic Fatigue Immunodeficiency Syndrome (CFIDS) -- what used to be more simply called chronic fatigue syndrome has been expanded to recognize its immune involvement. It is accompanied by symptoms other than fatigue such as muscle pain, sore throat, tender lymph nodes, and memory loss. A diagnosis is difficult, and generally, if the fatigue decreases daily functioning by 50 percent, is not lessened by rest, and persists for at least six months, then along with the presence of the other symptoms, a diagnosis is made. This is not a book for CFIDS sufferers, but the recommendations given may still help.
   
   
9. Fibromyalgia -- characterized by painful muscles, tendons, and ligaments, fibromyalgia can also cause constant fatigue and recurring headaches. A diagnosis is often made by assessing pain when applying pressure to the eighteen "tender points" on the body. One of the best treatments to date is pain management.
   
   
10. Fatigue can also be a symptom of mononucleosis or the EpsteinBarr virus, cancer or heart disease, arthritis or allergies, Lyme disease or digestive diseases.

Again, please don't let these potential medical conditions alarm you too much. The chances are slim that you have one of these health problems, but at the same time, however, I also don't want you to completely disregard the possibility. If you think that an underlying health problem may be the cause of your fatigue, I urge you to consult a skilled, empathetic physician and have some screening tests to identify a potential illness or rule it out. Even if you don't think an illness is your culprit, after reading this book and implementing the recommended changes, if you still find yourself at the same level of debilitating fatigue, make an appointment with your physician for a thorough exam.

So now you know that your fatigue is definitely not telling you that you need to get a new life, blame yourself, or take external and unnatural "energy boosters." And you know that your fatigue is probably not telling you that you need to identify and treat a major illness.

Next, I want to help you figure out what your fatigue is really trying to tell you -- the universal answers to your female energy crisis, the choices you make every day in how you live. Your fatigue may be begging you to make other choices to take care of your body from the inside out. Your body may be telling you that it desperately needs to be replenished by one or more of the 8 natural energy sources:

1. Food: You need to sink your teeth into caloric energy. A meal or a snack, some carbohydrate, some protein, or (are you ready for this?) some fat. Inadequate fat intake causes inadequate energy. Low calories cause low energy. Food is your body's primary energy source, and eating is a woman's foremost and immediate energy stabilizer.
   
   
2. Water: You need to take a sip of hydraulic energy. Dehydration is one of the top causes of fatigue for women, so heightened energy may be just a few glasses away. Cool, refreshing, thirst-quenching water hydrates all 75 trillion cells, especially your brain cells. Your brain is 75 percent water! So a water-deprived brain is an energy-deprived brain.
   
   
3. Fitness: You need to power your body with physical energy. An out-of-shape body can lead to out-of-this-world fatigue. Only 20 percent of us exercise consistently enough to power our muscles, hearts, lungs, and entire bodies. The rest of us would experience at least a 25 percent jump in energy if we jumped off the couch to move our bodies.
   
   
4. The Great Outdoors: You need to surround yourself with natural energy. Get some sunshine, breathe some fresh air, take in the beauty of Mother Nature. The sights, smells, and sun are immediately invigorating. Hiding from the sun and the outdoors with sunblock, sunglasses, and sun hat is hiding from an important energy source. We're all concerned about skin cancer and premature aging, but ten minutes with Mother Nature is all you need.
   
   
5. Sleep: You need to recharge your battery with restorative energy. On average, we're getting only 80 percent of the sleep we need each night, and when we're in menopause, it can drop as low as 50 percent. Sleep allows your body to repair damage, recover from stress, and restore balance. A good night's sleep leads to a good, productive day.
   
   
6. Intimacy: You need to tap into your sensual energy. Time spent with friends, lovers, children, and animals is rejuvenating time. But time spent being loving and kind to yourself may be the most energizing of all. The more confident and assured you feel about yourself and your body, the more pleasure you'll get out of every waking moment.
   
   
7. Joy: You need to tickle your soul with comic energy. Smile! Laugh! Snicker! Snort! Giggle! Guffaw! We need it; half of all women say that they feel sad at any given moment, so part of our fatigue may be our sadness talking, telling us we're emotionally drained from despair, worry, guilt, and anxiety. Laughter can help lighten our mood and lift our energy.
   
   
8. Balanced Stress: You need to calm your chaotic energy. Daily, chronic stress keeps us running around in circles with no reprieve. The only way to break free from this chaotic madness is to purposefully slow down, make it a priority to rest, and consciously choose where you expend your energy.

These are your 8 natural energy sources that are always at your fingertips. When you grasp them, they are your 8 energizing strategies to lifelong vitality. Sometimes your body will tell you it needs more of one strategy than another -- but together these strategies are your solution to outsmarting your female fatigue!

Outsmarting Female Fatigue
by Debra Waterhouse, M.P.H., R.D.

©2001. Reprinted with permission of the publisher, Hyperion, New York. http://www.hyperionbooks.com

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